Clin Med: Pulmonary Vascular Disorders

Question 1

Pulmonary Circulation route

Answer 1

RV
Pulmonary trunk
L and R Pulmonary arteries
re-enter via pulmonary veins into the LA

Question 2

Pulmonary trunk is how big

Answer 2

5 cm

Question 3

main branches of the pulm arteries are about ______ of the aortas thickness

Answer 3

1/3

Question 4

Hypoxia will trigger

Answer 4

vasoconstriction

Question 5

Vasoconstriction in the lungs will lead to

Answer 5

shunting of blood to the more aerated areas within the lung —> so other areas get more blood

Question 6

If the entire lung is vasoconstricted this can lead to

Answer 6

pulm HTN

Question 7

Pulmonary lymphatics remove

Answer 7

both infectious material and excess fluid

Question 8

Pulmonary lymphatics drain into

Answer 8

the right thoracic lymphatic duct

Question 9

Pulmonary embolism is

Answer 9

a blood clot within the pulmonary vasculature

Question 10

Causes of PE’s

Answer 10

DVT
fat embolism
air embolism
amniotic embolism

Question 11

Treatment for PE

Answer 11

provoked - 3 month anticoag
unprovoked - forever anticoag
tPA (severe sx)

Question 12

Fat embolism occurs with injury to

Answer 12

long bones - femur fracture

Question 13

Septic emboli most commonly associated with

Answer 13

IVDU and s. aureus - will affect right side of the heart

Question 14

Air embolism is most commonly due to

Answer 14

scuba diving
iatrogenic

Question 15

In an air embolism bubbles enter

Answer 15

the pulmonary circulation and lodge in the same fashion a clot would

Question 16

On physical exam what would you find with an air embolism

Answer 16

crepitus

Question 17

Amniotic embolism is when

Answer 17

amniotic fluid is able to get into Mom’s circulation
m/c occurs during lab or immediate postpartum

Question 18

Amniotic embolism tx

Answer 18

treat like it is a clot - anticoag, tPA if not stable
watch for bleeding to death since she just gave birth and will be on anticoags - have OB/GYN with you to counteract these

Question 19

PE presentation

Answer 19

pleuritic chest pain (breathing pain)
SOB, hypoxia
syncope
shock (right sided HF)
findings of DVT
cough
hemoptysis
tachycardia

Question 20

Classifications of PEs

Answer 20

Massive - hemodynamically unstable
Submassive - without right sided heart strain

Question 21

Complications of a PE

Answer 21

right sided heart failure
decreased gas exchange - lack of profusion leading to lung ischemia

Question 22

Pulmonary HTN is

Answer 22

elevation in the normal pulmonary vasculature leading to increased RV pressure

Question 23

Treatment of Pulm HTN

Answer 23

inhaled agents - nitro

Question 24

EKG findings in a PE

Answer 24

S1 Q3 T3

Question 25

PE can result in

Answer 25

Pulmonary HTN

Question 26

Classifications of Pulm HTN

Answer 26

group 1
group 2
group 3
group 4
group 5

Question 27

PULM HTN - Group 1

Answer 27

idiopathic, familial, drug/toxin, connective tissue disease, congenital (Primary)

Question 28

PULM HTN - Group 2

Answer 28

secondary cause of LV dysfunction - pulmonary venous hypertension

Question 29

PULM HTN - Group 3

Answer 29

chronic lung diseases

Question 30

PULM HTN - Group 4

Answer 30

PE

Question 31

PULM HTN - Group 5

Answer 31

IDK

Question 32

Cor Pulmonale is

Answer 32

downstream cardiac effect of PE and Pulm HTN that leads to hypertrophy and dilation of the RV

Question 33

Causes of pulmonary vasoconstriction

Answer 33

chronic hypoxemia
acidosis

Question 34

Cor pulmonale presentation mirrors

Answer 34

right sided heart failure